Affiliate- Application

Affiliate- Application

Beliefnet Partner Network


Site Information
Site Name:
URL of Site:

Mailing Address
Address 1:
Address 2:
City:
State:
Province:
Postal Code:
Country:
Phone:        Fax:  

Primary Contact
Name:
Title:
Phone:        Fax:  
E-Mail:

Pay To Address
Same as above
Pay To Name:
Address 1:
Address 2:
City:
State:
Province:
Postal Code:
Country:

Accounting Contact
Same as above
Name:
Title:
Phone:        Fax:  
E-Mail:

Technical Contact
Same as above
Name:
Title:
Phone:        Fax:  
E-Mail:
Pager:

Please provide a preferred username and password for future on-line reporting:
Requested Username:
Requested Password:
Confirm Password:

Important Information
By filling in this section, you will help us determine whether you will be placed in our Affiliate Advertising Network.  Please fill out these questions to the best of your ability.

What is the primary categorical classification of your web site?
What are the categorical classifications of your web site?

Auto Corporate Info Directories
Education Entertainment Family/Lifestyles
Finance Government News/Information
Online Communities Personal Search Engines
Shopping Sports Sweepstakes/Coupons
Telecommunications/Internet Travel Other
If "Other", please specify:
How many unique users visit your web site each month?
How many page views are logged on your web site each month?
What is your business tax classification?
What is your Social Security Number (individual) or Federal Tax ID (corporation)?
What is the date your site was established?


DiggDeliciousNewsvineRedditStumbleTechnoratiFacebook